McAlpine's Multiple Sclerosis

Abstract

SECTION ONE: THE STORY OF MULTIPLE SCLEROSIS 1. The story multiple sclerosis The evolving concept multiple sclerosis Naming and classifying the disease: 1868-1983 Clinical descriptions multiple sclerosis: 1838-1981 Personal accounts multiple sclerosis: 1824-1991 The social history multiple sclerosis: 1945-1998 The pathogenesis and clinical anatomy multiple sclerosis: 1849-1977 The laboratory science multiple sclerosis: 1912-1981 Discovery glia and remyelination: 1858-1988 The aetiology multiple sclerosis: 1883-1976 Attitudes to the treatment multiple sclerosis: 1841-1983 SECTION TWO: THE CAUSE AND COURSE OF MULTIPLE SCLEROSIS 2. The distribution multiple sclerosis The rationale for epidemiological studies in multiple sclerosis Definitions and statistics in epidemiology Strategies for epidemiological studies in multiple sclerosis The geography multiple sclerosis Epidemics and clusters multiple sclerosis The environmental factor in multiple sclerosis 3. The genetics multiple sclerosis: Genetic analysis multiple sclerosis Methods genetic analysis Racial susceptibility Sex differences in susceptibility Familial multiple sclerosis Candidate genes in multiple sclerosis Systematic genome screening Lessons from genetic studies experimental allergic encephalomyelitis Conclusions 4. The natural history multiple sclerosis Introduction Definitions Onset Course Inter-individual variability Factors affecting the prognosis General considerations Environmental influences Chapter 5: The aetiology multiple sclerosis: an epitome SECTION THREE: THE CLINICAL FEATURES AND DIAGNOSIS OF MULTIPLE SCLEROSIS 6. The symptoms and signs multiple sclerosis. Multiple sclerosis as a neurological illness Initial symptoms Symptoms and signs in the course the disease Individual symptoms and sign Associated diseases Conclusion 7. The diagnosis multiple sclerosis Diagnostic criteria for multiple sclerosis Selection investigations Magnetic resonance imaging Evoked potentials Examination the cerebrospinal fluid A strategy for the investigation demyelinating disease 8. The differential diagnosis multiple sclerosis The spectrum disorders mimicking multiple sclerosis Diseases that may cause multiple lesions the CNS and also often follow a relapsing remitting course Systematized central nervous system diseases Isolated or monosymptomatic CNS syndromes Non organic symptoms How accurate is the diagnosis multiple sclerosis? 9. Multiple sclerosis in the individual and in groups: a conspectus The typical case Isolated syndromes and their outcome: judicious use investigations and critique the new diagnostic criteria Co-morbidity and associated diseases Situations in which alternative diagnoses should be considered When to ignore inconvenient laboratory results or clinical findings: taking the best position Pathognomonic and un-heard of features multiple sclerosis SECTION FOUR: THE PATHOGENESIS OF MULTIPLE SCLEROSIS 10. The neurobiology multiple sclerosis. Organisation in the central nervous system Development the central nervous system Macroglial lineages in the rodent and human nervous system Axon-glial interactions and myelination Demyelination Axon degeneration and restoration function Remyelination 11. The immunology inflammatory demyelinating disease Multiple sclerosis as an autoimmune disease Immune responses: innate and adaptive T lymphocytes B lymphocytes Autoimmunity and self tolerance in the central nervous system Regulation central nervous system autoimmune responses Immune reactivity in the central nervous system Pathogenesis demyelination and tissue damage Peripheral blood biomarkers for multiple sclerosis and disease activity Markers multiple sclerosis and disease activity in cerebrospinal fluid Conclusion 12. The pathology multiple sclerosis Introduction Pathological classification demyelinating diseases The demyelinated plaque Immunopathology inflammation Demyelination and oligodendroglial damge Remyelination Axonal pathology Grey matter pathology / cortical plaques Astroglia reaction Abnormalities in the normal white matter Distribution lesions in the nervous system Is there evidence for an infectious agent in the lesions multiple sclerosis? Dynamic evolution multiple sclerosis pathology Differences between acute relapsing and progressive multiple sclerosis Molecular approaches to the study the MS lesion: Global profiling transcriptome and proteome. Association multiple sclerosis with other diseases Conclusions 13. The pathophysiology multiple sclerosis Introduction Methods for exploring the pathophysiology multiple sclerosis Relapsing remitting multiple sclerosis: loss function due to conduction block Relapsing remitting multiple sclerosis: recovery function and remission Physiological explanations for other clinical symptoms in multiple sclerosis Permanent loss function in the context disease progression Summary SECTION FIVE: THE TREATMENT OF MULTIPLE SCLEROSIS 15. Care the person with multiple sclerosis General approach to the care people with multiple sclerosis The early stages disease: minimal disability The middle stages disease: moderate disability The later stages disease: severe disability Guidelines for the management and investigation multiple sclerosis Conclusion 16. Treatment the acute relapse The features active multiple sclerosis The treatment relapse in multiple sclerosis Other approaches to the treatment acute relapse Treatment acute optic neuritis Management other central nervous system demyelinating disorders Adverse effects corticosteroids Mode action corticosteroids Practice Guidelines 17. The treatment symptoms in multiple sclerosis and the role rehabilitation The general principles symptomatic treatment in multiple sclerosis Disturbances autonomic function Mobility and gait disturbance Fatigue Disturbances brain stem function Perturbations nerve conduction Cognition Visual symptoms Rehabilitation in multiple sclerosis Summary 18. Disease modifying treatments in multiple sclerosis The aims disease modifying treatment The principles evidence based prescribing in multiple sclerosis The role magnetic resonance imaging in clinical trials Drugs that stimulate the immune response Drugs that non-specifically suppress the immune response The beta interferons Molecules that inhibit T cell-peptide binding Specific treatments that target T cells Agents which inhibit macrophages and their mediators Recent miscellaneous treatments Postscript 19: The person with multiple sclerosis: present and future Empirical versus hypothesis driven therapeutics New opportunities for immunological intervention Axon protection acute and chronic Treatment in special situations Remyelination: Index